Early Signs of Dementia in Women: Symptoms to Know

Key takeaways

More women than men are living with Alzheimer’s. Here are some tips on prevention and diagnosis:

• Know your risk—age, genetics, and family health history play a role in Alzheimer’s risk.
• Watch for early signs of dementia like getting lost in familiar places, having trouble finding words, and forgetting to pay bills.
• Learn your Brain Care Score ™ and how simple lifestyle changes can improve brain health.
• Read the latest research from Mass General Brigham Neuroscience Institute into prevention, diagnosis, and treatment of Alzheimer’s and other brain conditions.

Alzheimer’s disease (AD) is the most common cause of dementia in older adults. Many people wonder: Does the disease affect men and women the same way?

The answer is a bit complicated, says Alexandra Touroutoglou, PhD, a neurology scientist with Mass General Brigham Neuroscience Institute. Dr. Touroutoglou works at the Mass General Research Institute and is director of imaging operations at Mass General's Frontotemporal Disorders Unit.

Dr. Touroutoglou explains why more women than men are living with AD, how to recognize early symptoms of the disease, and what progress is being made in Alzheimer’s research. Dr. Touroutoglou’s latest research investigates how MRI scans can help predict Alzheimer’s progression.

Alzheimer’s disease risk factors

In the United States, almost 2 in 3 people with Alzheimer’s disease are female. Women’s lifetime risk of developing Alzheimer’s is 1 in 5, while men’s lifetime risk is 1 in 10. But those numbers are somewhat misleading, Dr. Touroutoglou says. As people get older, their risk of AD goes up. Since women live longer than men, there are also more older women living with AD. Researchers are finding that there may be important differences in how Alzheimer’s disease develops and progresses in men and women.

When you look at men and women of the same age, it’s not clear that women are at greater risk. “The research on this has been inconclusive,” she says. Some studies suggest that biological differences between men and women such as genetic differences or hormones like estrogen may play a role in the risk for developing AD. Scientists are still exploring these complex relationships, however.

It’s clear, though, that three main factors increase the risk of Alzheimer’s dementia, regardless of gender:

1. Age: Aging is the most important risk factor for AD. Although there is a form of AD that affects people younger than 65, most people with the disease are older. AD affects 1 in 9 people over 65.
2. Genetics: Researchers have found a few genes linked to an increased risk. The most important gene identified so far is called APOE-e4.
3. Family health history: People with a parent or sibling with AD are more likely to develop the disease themselves.

Early signs of Alzheimer’s disease

Most people experience some changes in their memory as they get older. “Forgetfulness is a normal part of aging. You might forget someone’s name, for example, or go into a room and say to yourself, ‘What was I coming in here to do?’,” Dr. Touroutoglou says. “If you can retrace your steps to remember what you were doing, or recall something later with a reminder, that’s normal forgetting.”

Normal forgetting doesn’t interfere with your ability to live independently. “In Alzheimer's disease, the forgetting begins to disrupt a person’s independence and daily life and sometimes even their safety,” she adds.

Common early signs of AD include:

• Asking the same questions over short period of time
• Frequently misplacing things
• Word-finding difficulties (trouble remembering words when speaking and writing) or using the wrong word for familiar items
• Difficulty with planning and problem-solving
• Forgetting to pay the bills or forgetting that you bought something and buying it again
• Withdrawal from social activities
• Changes in mood and personality, such as developing depression or anxiety
• Getting lost in a familiar area

These changes are common in people of all genders who develop AD. “If you or a loved one are experiencing these signs, the best thing to do is to talk to your doctor and make an appointment to see a specialist,” Dr. Touroutoglou says.

Dementia research at Mass General Brigham

Mass General Brigham Neuroscience Institute researchers are leaders in research on Alzheimer’s disease and other types of dementia. That research may lead to better diagnosis, new treatments, and new methods for preventing memory loss.

Learning from “superagers”

Dr. Touroutoglou and her colleagues study older adults who maintain excellent memory and brain function well into late life. These older adults are called “Superagers,” and they may hold clues to preventing dementia. “Memory decline may be a normal part of aging, but it’s not inevitable. Some older adults avoid the brain shrinkage and memory loss that typically go along with aging,” she explains. “Their brains remain youthful—imagine a 25-year-old brain in a 75-year-old body.”

Alzheimer’s disease is thought to be mainly caused by two proteins in the brain, tau and beta amyloid. Interestingly, some superagers Dr. Touroutoglou studies have beta amyloid in their brains, but it doesn’t seem to cause dementia symptoms. “They somehow manage to remain free of AD-related symptoms, despite the fact that they have similar levels of amyloid in their brains as typical older adults,” she says. Superagers, she found, seem to have more connections between brain cells than do other older adults. “Studying superagers may lead us to discover new ways to prevent or treat dementia,” she says.

A new treatment for memory symptoms

Dr. Touroutoglou and her team’s research into superagers led to an Alzheimer’s clinical trial treating people with early AD using transcranial magnetic stimulation (TMS).

TMS uses magnetic fields to stimulate brain cells. The goal is to help improve abnormal connections between brain regions and, hopefully, reduce memory loss and other symptoms of AD.

In a clinical test with a 70-year-old patient with cognitive symptoms, Dr. Touroutoglou and her colleagues found that TMS treatment improved his language impairments. They also saw new functional connections in the language part of the brain on scans.

In another clinical study with a 76-year-old patient with a rare form of Alzheimer’s disease that affects memory and visual abilities, Dr. Touroutoglou and her colleagues used brain scans to identify the best area of the brain to stimulate. They found that TMS treatment strengthened weak connections between brain regions and improved some visual memory abilities. The research team is now testing TMS in larger groups of people with Alzheimer’s disease.

Earlier Alzheimer’s diagnosis with MRI

“Early diagnosis and treatment gives people with Alzheimer’s more time,” says Dr. Touroutoglou. “Our team investigates ways to diagnose and treat Alzheimer’s disease and dementia and help ease symptoms.”

Dr. Touroutoglou and her team’s latest research identified a pattern of brain atrophy (shrinking) that could predict progression timelines in early-onset Alzheimer’s disease. Alzheimer’s progression doesn’t have a standard pattern or timeline. This is one of the most frustrating parts of an Alzheimer’s diagnosis for the person and their loved ones.

“If we can use an MRI that is already part of the diagnostic process to better estimate how quickly someone’s disease may progress, we could help patients and families plan ahead and help clinicians make more personalized decisions about care,” says Dr. Touroutoglou.

More precise diagnosis can help doctors better care for their patients and can help lead to improved treatments.

Mass General Brigham Neuroscience Institute is at the forefront of Alzheimer’s research.

Researchers across Mass General Brigham study Alzheimer’s disease and dementia to help diagnose and treat the disease earlier. Our scientists:

• Evaluate new ways to reliably identify early-onset Alzheimer’s disease to help patients get a diagnosis and critical treatment sooner
• Use artificial intelligence (AI) to diagnose early-onset dementia and other neurodegenerative diseases
• Study stem cells and their impact on sleep-related symptoms in Alzheimer’s
• Develop simple at-home tests to detect cognitive impairment years before symptoms develop

Preventing Alzheimer’s dementia

Dr. Touroutoglou and her colleagues continue to study new ways to prevent AD. But already, science has pointed toward behaviors that can help protect against the disease.

Mass General Brigham researchers developed the McCance Brain Care Score™ (BCS) to help people understand and improve their brain health. Making lifestyle changes can help reduce your risk of dementia, stroke, and depression.

These activities may help reduce your risk of dementia:

• Cognitive training: “It is unclear if playing brain games on your phone or computer will help,” Dr. Touroutoglou says. “But you can increase the odds of a healthy brain by engaging in activities such as reading, socializing, and learning a new skill,” she says.
• Heart health: Heart disease is a risk factor for dementia. Controlling blood pressure and taking other steps to keep your heart healthy may also protect your brain.
• Eat well: A healthy diet has been linked to a lower risk of dementia. “A heart-healthy diet is also a brain-healthy diet,” Dr. Touroutoglou says.
• Exercise: Regular physical activity can improve your brain health. “You don’t have to start running a marathon. But you want to make sure you remain physically active. You should talk to your doctor to see what makes sense for you,” she says.

The thought of memory loss can be troubling for aging adults, especially in people with an increased genetic risk of Alzheimer's. But people can continue to live meaningful lives after a dementia diagnosis. When you recognize the early signs of the disease, you can get a timely diagnosis and begin to make plans for managing symptoms.